Doctor Answers 10

Lidocaine is not necessary for Botox treatments

September 19th, 2013

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Most likely the lidocaine would not effect the efficacy of the medicine, however it won't make your injection any more comfortable. The mild discomfort associated with a Botox injection is due to the needle and the tiny amount of medicine that comes out. The injection is over and done with before the lidocaine can have any effect. In fact, the lidocaine may burn more than the saline because it has a lower pH.

My patients report their injections are pretty much painless just using a cold pack as a topical anesthetic. If you are having significant discomfort from the injections, I would consider a topical numbing cream like Emla or BLT (benzocaine/lidocaine/tetracaine). Ask your injector for your options.

Diluting Botox with 1% Lidocaine

September 19th, 2013

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Yes you can dilute botox with 1% lidocaine and you will have the same effect. However the injection will sting because of the ph in lidocaine and the area will be numb for about 30 minutes. The Botox and normal saline will not sting. The way I inject Botox is gentle, I use a small fine needle, little topical anesthetic and icing and the injection is painless.

Diluting Botox with lidocaine

September 16th, 2013

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Botox is reconstituted normally with saline, sometimes preserved, sometimes not, depending on the physician. There is actually a mild anesthetic effect to the saline, and the pH is such that there is almost no discomfort with the injection. The lidocaine is much less studied, would hurt more, and is not something I'd recommend for any reason. ~ Dr. Benjamin Barankin, Toronto Dermatology Centre

Can you dilute Botox with Lidocaine instead of Saline

September 16th, 2013

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Strange timing that you ask this question, as an international report just came out talking about the different effects of diluting Botox with lidocaine vs saline. Because lidocaine will stop immediate movement because it numbs, some thought it might actually make a Botox injection more effective. Turns out, not so much. One outcome was that patients thought the Botox hurt A LOT more when only diluted with lidocaine. Plus, the FDA approved way to dilute Botox is with saline. Stick with what works and has been proven to work for a loooooong time.

"This answer has been solicited without seeing this patient and cannot be held as true medical advice, but only opinion. Seek in-person treatment with a trained medical professional for appropriate care."

Dilute with normal saline

September 15th, 2013

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We have been using Botox for over 10 years and we only dilue with normal saline and that is because we know it works. We have tried other dilutents. Pain is not a problem with injection of Botox for our patients. I would recommend injection only by a properly licensed board certified dermatologist or plastic surgeon.

Don't dilute Botox with lidocaine

September 15th, 2013

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The FDA approved way to dilute Botox is with saline. Bacteriostatic saline (with preservative) is most commonly used because it does not hurt as much as some other diluents. Although theoretically Botox would probably still work if diluted with lidocaine, I would not recommend this. If your provider uses bacteriostatic saline and a small (30-32 gauge) needle, the procedure should be very quick and well tolerated with minimal discomfort.

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